Journal of Nippon Medical School最新文献_第3页

Unexpressed Support Needs and Social Distress in Working-Age Cancer Survivors: A Web-Based Cross-Sectional Study in Japan. 日本工作年龄癌症幸存者未表达的支持需求和社会困扰：一项基于网络的横断面研究。

IF 1.8 4区医学

Journal of Nippon Medical School Pub Date : 2026-01-01 DOI: 10.1272/jnms.JNMS.2026_93-110

Kazuho Hisamura, Miyo Kimura, Yoshiharu Motoo, Eisho Yoshikawa

{"title":"Unexpressed Support Needs and Social Distress in Working-Age Cancer Survivors: A Web-Based Cross-Sectional Study in Japan.","authors":"Kazuho Hisamura, Miyo Kimura, Yoshiharu Motoo, Eisho Yoshikawa","doi":"10.1272/jnms.JNMS.2026_93-110","DOIUrl":"10.1272/jnms.JNMS.2026_93-110","url":null,"abstract":"Background: Cancer patients of working age often face multiple social challenges that remain unrecognized and unmet. The current study aimed to examine the adequacy of social support and unexpressed support needs for social problems among working-age cancer patients in Japan.Methods: A web-based cross-sectional survey was conducted among 683 cancer patients aged 20-64 years. Using the Social Problem Checklist for Working-age Cancer Patients, we assessed the severity of social problems, the sources of support consulted, and the adequacy of support received. We analyzed differences in the adequacy of support by source and identified social problems associated with unexpressed and unmet support needs using dot diagrams.Results: Although many participants experienced severe social problems, a substantial proportion reported either not perceiving a need for support or not expressing their support needs. Unexpressed needs were most common in domains related to loneliness, intimate relationships, and sexuality. Adequate support was more frequently reported when non-family sources were consulted, particularly when patients accessed both family and non-family support. Patients who relied solely on family reported support adequacy levels that were similar to those who consulted no one.Conclusions: Many working-age cancer patients in Japan experience significant social distress but do not voice their support needs, particularly regarding sensitive topics. Support from non-family sources plays a key role in addressing unmet and unexpressed needs. These findings highlight the importance of multidisciplinary psychosocial care and proactive efforts to identify hidden distress and diversify support networks for working-age cancer patients.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"93 1","pages":"37-48"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Practical and Cost-Effective Use of Open-Surgery-Type Ultrasound Probes in Laparoscopic Hepatectomy: A Single-Center Experience with over 150 Cases. 开放式超声探头在腹腔镜肝切除术中的实用和成本效益：150多例单中心经验。

IF 1.8 4区医学

Journal of Nippon Medical School Pub Date : 2026-01-01 DOI: 10.1272/jnms.JNMS.2026_93-112

Yoichi Kawano, Yukio Ohshiro, Tetsuya Shimizu, Junji Ueda, Takahiro Murokawa, Yuto Aoki, Takashi Ono, Akira Hamaguchi, Toshiyuki Irie, Akihisa Matsuda, Akira Matsushita, Masato Yoshioka, Nobuhiko Taniai, Hiroshi Yoshida

{"title":"Practical and Cost-Effective Use of Open-Surgery-Type Ultrasound Probes in Laparoscopic Hepatectomy: A Single-Center Experience with over 150 Cases.","authors":"Yoichi Kawano, Yukio Ohshiro, Tetsuya Shimizu, Junji Ueda, Takahiro Murokawa, Yuto Aoki, Takashi Ono, Akira Hamaguchi, Toshiyuki Irie, Akihisa Matsuda, Akira Matsushita, Masato Yoshioka, Nobuhiko Taniai, Hiroshi Yoshida","doi":"10.1272/jnms.JNMS.2026_93-112","DOIUrl":"10.1272/jnms.JNMS.2026_93-112","url":null,"abstract":"Background: Laparoscopic hepatectomy (Lap-H) is increasingly being performed in Japan, but the high cost and handling complexity of laparoscopic ultrasonographic (US) probes remain a barrier to its wider adoption. Intraoperative ultrasonography is essential for safe liver resection; however, specialized laparoscopic probes are expensive, have a limited field of view, and are difficult to manipulate.Methods: To overcome these limitations, we developed a practical technique using an open-surgery-type microconvex US probe in Lap-H. The probe is inserted via an umbilical incision using a Lap Protector mini™ and EZ Access™, and probe manipulation is achieved through a cord-based control system. We applied this method in over 150 Lap-H cases before the introduction of a dedicated laparoscopic US system.Results: This technique enabled the acquisition of axial and sagittal images with a wide and deep field of view, enhancing anatomical orientation and lesion visualization. There were no complications such as air leaks or equipment failure. The method allowed for the use of contrast-enhanced ultrasound and minimized interference with the operative field.Conclusions: The use of open-surgery-type US probes in Lap-H offers a cost-effective, safe, and practical alternative to expensive laparoscopic US systems. This innovation may lower the barrier for institutions initiating Lap-H programs and promote the broader adoption of high-quality intraoperative ultrasonography in minimally invasive liver surgery.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"93 1","pages":"60-66"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Placenta-Specific miRNA miR-515-3p Suppresses HMGB3 Expression in the Breast Cancer Cell Line MCF-7. 胎盘特异性miRNA miR-515-3p抑制乳腺癌细胞系MCF-7中HMGB3的表达

IF 1.8 4区医学

Journal of Nippon Medical School Pub Date : 2026-01-01 DOI: 10.1272/jnms.JNMS.2026_93-206

Ai Sato, Hiroyuki Takei, Syunya Noguchi, Toshihiro Takizawa

{"title":"Placenta-Specific miRNA miR-515-3p Suppresses HMGB3 Expression in the Breast Cancer Cell Line MCF-7.","authors":"Ai Sato, Hiroyuki Takei, Syunya Noguchi, Toshihiro Takizawa","doi":"10.1272/jnms.JNMS.2026_93-206","DOIUrl":"10.1272/jnms.JNMS.2026_93-206","url":null,"abstract":"Background: Pregnancy-related breast cancer is relatively rare, but its incidence is increasing as the age of childbearing advances. The impact of placenta-specific microRNAs (miRNAs) derived from the chromosome 19 miRNA cluster (C19MC) on pregnancy-associated breast cancer is unclear. Nuclear protein high mobility group box 3 (HMGB3) plays a role in cancer progression. This study examined the effects of placenta-specific C19MC miRNAs on the cancer-related gene HMGB3 in the human breast cancer cell line MCF-7.Methods: We used target gene prediction programs to identify C19MC miRNAs that modulate HMGB3 and then validated them using analytical procedures (i.e., quantitative PCR, Western blot, and luciferase reporter assay). We investigated how inhibition of HMGB3 by C19MC miRNAs affects the invasive and proliferative ability of MCF-7 cells and explored the downstream effectors of this axis.Results: C19MC miRNA miR-515-3p targeted HMGB3. In MCF-7 cells, reduction of HMGB3 expression by miR-515-3p increased cell invasion and proliferation. Furthermore, miR-515-3p-mediated HMGB3 inhibition led to the upregulation of CTNNB1 and GRB2, implicating invasion- and proliferation-related signaling pathways (e.g., WNT/β-catenin, Ras/MAPK, and PI3K/AKT/mTOR) in MCF-7 cells.Conclusions: The impact of C19MC miRNA miR-515-3p on the cancer-related gene HMGB3 in MCF-7 cells suggests a potential tumor-suppressive role for HMGB3 that contrasts with previous reports of oncogenic activity. The present findings raise the possibility that placenta-specific C19MC miRNAs play a role in pregnancy-related breast cancer during pregnancy.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"93 2","pages":"122-134"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Response to "Comment on the ESCORT Study: Atrial Fibrillation Detection by Pulse Checking Remains Challenging". 对“对ESCORT研究的评论：通过脉搏检查检测房颤仍然具有挑战性”的回应。

IF 1.8 4区医学

Journal of Nippon Medical School Pub Date : 2026-01-01 DOI: 10.1272/jnms.JNMS.2026_93-405

Takehiro Katano

引用次数: 0

Serum Selenium Concentration in Neurosurgery Patients Receiving Parenteral Nutrition. 接受肠外营养的神经外科患者血清硒浓度。

IF 1.8 4区医学

Journal of Nippon Medical School Pub Date : 2026-01-01 DOI: 10.1272/jnms.JNMS.2026_93-310

Kenta Koketsu, Kyongsong Kim, Riku Mihara, Hiroyuki Dan, Tomohiro Ozeki, Hiroaki Fujita, Minoru Ideguchi, Yasuo Murai

{"title":"Serum Selenium Concentration in Neurosurgery Patients Receiving Parenteral Nutrition.","authors":"Kenta Koketsu, Kyongsong Kim, Riku Mihara, Hiroyuki Dan, Tomohiro Ozeki, Hiroaki Fujita, Minoru Ideguchi, Yasuo Murai","doi":"10.1272/jnms.JNMS.2026_93-310","DOIUrl":"https://doi.org/10.1272/jnms.JNMS.2026_93-310","url":null,"abstract":"Background: Selenium is an important trace element that helps maintain physiological functions. We calculated the incidence of selenium deficiency in enterally and parenterally fed patients with acute neurologic disorders.Methods: We enrolled 39 consecutive patients who received enteral and/or parenteral nutrition for 14 days or longer (23 men, mean age 74.6 years). Serum selenium was recorded on admission and at 2 weeks and 1 month thereafter. Low selenium was defined as a level lower than 107 μg/L. A diagnosis of selenium deficiency was based on the clinical guidelines for selenium deficiency.Results: The mean serum selenium level at admission was 119.9 μg/L in 38 patients but was lower in the 39th patient, who had undergone prolonged tube feeding. There was a weak negative correlation between selenium level and patient age, and when the age cutoff for detecting low selenium was set to 75 years, the sensitivity was 91.7% and the specificity was 53.8%. No selenium-deficient patients presented with clinical symptoms associated with selenium deficiency (all had subclinical low selenium). Selenium was normal in 26 patients, although 2 presented with low selenium 2 weeks post-admission. At 1 month after admission, no patient had a low selenium level.Conclusion: Our findings suggest that selenium measurement on admission may be advisable for patients aged 75 years or older and for those undergoing hemodialysis or prolonged tube feeding. Selenium deficiency is a concern when neurosurgery patients with acute neurologic disorders are fed enterally or parenterally.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"93 3","pages":"252-258"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnosis and Treatment of Clostridioides difficile Infection. 艰难梭菌感染的诊断与治疗。

IF 1.8 4区医学

Journal of Nippon Medical School Pub Date : 2026-01-01 DOI: 10.1272/jnms.JNMS.2026_93-106

Jun Hirai

{"title":"Diagnosis and Treatment of Clostridioides difficile Infection.","authors":"Jun Hirai","doi":"10.1272/jnms.JNMS.2026_93-106","DOIUrl":"10.1272/jnms.JNMS.2026_93-106","url":null,"abstract":"Clostridioides difficile infection (CDI) remains a leading cause of healthcare-associated diarrhea worldwide, with high morbidity, recurrence, and healthcare burden. Timely and accurate diagnosis, effective treatment, and preventive strategies are critical in improving patient outcomes. This review presents a comprehensive overview of CDI and focuses on diagnostic criteria, severity classifications, recurrence risk prediction, and therapeutic approaches, emphasizing both international and Japanese perspectives. The use of the Bristol Stool Scale and appropriate stool testing protocols helps ensure diagnostic accuracy and avoid overtreatment. Japan's adoption of the MN severity criteria, which incorporate clinical, laboratory, and imaging findings, contrasts with laboratory-based classifications in international guidelines. While both structured diagnostic algorithms and evidence-based treatment guidelines offer prognostic value, MN criteria may better reflect real-world clinical decision-making in Japan. CDI recurrence remains a significant clinical challenge. This review highlights two predictive models-CHIEF score and the novel Days of Antibiotic Spectrum Coverage (DASC) metric-developed in Japanese cohorts. Both tools enable early identification of high-risk patients and support decisions on prophylactic or tailored therapy. Therapeutic options include fidaxomicin (FDX), vancomycin, and metronidazole (MTZ). Recent international guidelines favor FDX due to its superior microbiota-sparing properties and reduced recurrence rates. However, MTZ remains an option for mild cases in Japan because of cost considerations and differences in CDI strain prevalence. By comparing local and global practices, this review underscores the importance of region-specific data in optimizing CDI management and encourages further integration of emerging risk stratification tools and treatment strategies to improve care across diverse clinical settings.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"93 1","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147437939","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Qualitative Analysis of Newspaper Articles to Standardize the Social Background of Simulated Patients: A Pilot Study on Caregiving. 报纸文章规范模拟病人社会背景的定性分析：一项关于护理的初步研究。

IF 1.8 4区医学

Journal of Nippon Medical School Pub Date : 2026-01-01 DOI: 10.1272/jnms.JNMS.2026_93-109

Terumichi Fujikura, Yumiko Okubo, Masahiko Inamori, Yoshiaki Hayasaka, Namiko Taniuchi

{"title":"Qualitative Analysis of Newspaper Articles to Standardize the Social Background of Simulated Patients: A Pilot Study on Caregiving.","authors":"Terumichi Fujikura, Yumiko Okubo, Masahiko Inamori, Yoshiaki Hayasaka, Namiko Taniuchi","doi":"10.1272/jnms.JNMS.2026_93-109","DOIUrl":"10.1272/jnms.JNMS.2026_93-109","url":null,"abstract":"Background: Public engagement in medical education, including the participation of simulated patients, has a favorable influence on students. In Objective Structured Clinical Examinations (OSCE) scenarios, the psychological and social aspects in the biopsychosocial model of the patient do not seem to have been adequately considered. The objective of this study was to identify a series of strategies to explore the concerns of the general public and reflect these concerns in the background characteristics of simulated patients. To enhance understanding, we will also discuss specific examples from studies.Methods: This study used qualitative document analysis of newspaper articles submitted by the general public. We searched for frequently occurring words in 1,127 articles, and 455 frequent words were selected as potential targets for this study. In this pilot study, the word \"caregiving\" was selected for analysis, and 43 articles containing this word were included in the database. Extracted texts were qualitatively analyzed using steps for coding and theorizing to generate emergent themes.Results: A storyline was obtained to establish the simulated patient background for the OSCE. We were able to integrate patient background, such as, \"a company employee who regrets not being able to provide the care he had envisioned while balancing work and caregiving.\"Conclusions: The background of simulated patients in medical education can be formulated through document analysis of newspaper articles. Future studies should attempt to verify the validity of this strategy.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"93 1","pages":"25-36"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147438013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Medical Resources and Clinical Outcomes for Extracorporeal Membrane Oxygenation Treatment under the Japanese Health Insurance System: A Single-Center Retrospective Observational Study. 日本健康保险制度下体外膜氧合治疗的医疗资源和临床结果：一项单中心回顾性观察研究。

IF 1.8 4区医学

Journal of Nippon Medical School Pub Date : 2026-01-01 DOI: 10.1272/jnms.JNMS.2026_93-311

Hiroshi Mase, Yuki Genda, Shunichi Yasuda, Takuya Nishino, Hiroki Yamaguchi, Masashi Ishikawa

{"title":"Medical Resources and Clinical Outcomes for Extracorporeal Membrane Oxygenation Treatment under the Japanese Health Insurance System: A Single-Center Retrospective Observational Study.","authors":"Hiroshi Mase, Yuki Genda, Shunichi Yasuda, Takuya Nishino, Hiroki Yamaguchi, Masashi Ishikawa","doi":"10.1272/jnms.JNMS.2026_93-311","DOIUrl":"10.1272/jnms.JNMS.2026_93-311","url":null,"abstract":"Background: Extracorporeal membrane oxygenation (ECMO) is a resource-intensive life support therapy associated with high complication rates. Blood products are a major cost driver, yet their impact on outcomes under the Japanese health insurance system remains unclear. This study investigated the association between transfusion burden and clinical outcomes in ECMO patients.Methods: We retrospectively analyzed data from 112 adult patients who received ECMO at Nippon Medical School Hospital between 2014 and 2023. Baseline characteristics, laboratory findings, and transfusion volumes of red blood cells (RBCs), fresh frozen plasma (FFP), and platelets were compared in relation to survival and death. Sixty-day mortality was assessed using Kaplan-Meier analysis and Cox proportional hazards models. Predictors of transfusion burden were evaluated with multivariable regression.Results: Transfusion of FFP (hazard ratio [HR] 2.00, 95% confidence interval [CI] 1.15-3.46) and RBCs (HR 2.37, 95%CI 1.14-4.93) were independently associated with increased 60-day mortality, whereas platelet transfusion was not. Nonsurvivors required significantly larger volumes of all blood products. Transfusion burden was primarily determined by longer ECMO duration and lower fibrinogen levels. Blood products accounted for 56.1% of drug-related expenditures during ECMO.Conclusions: Transfusion burden was a key determinant of mortality and cost in ECMO patients and was mainly affected by prolonged ECMO duration and low fibrinogen levels. These findings highlight the clinical and economic impact of transfusion practices and underscore the need for prospective multicenter validation to establish evidence-based transfusion strategies in Japan.","PeriodicalId":56076,"journal":{"name":"Journal of Nippon Medical School","volume":"93 3","pages":"259-268"},"PeriodicalIF":1.8,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148347586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comment on "Predictive Postoperative Inflammatory Response Indicators of Infectious Complications Following Gastrectomy for Gastric Cancer". 对“胃癌胃切除术后感染性并发症的预测炎症反应指标”的评论。

IF 1.4 4区医学

Journal of Nippon Medical School Pub Date : 2026-01-01 DOI: 10.1272/jnms.JNMS.2026_93-104

Hitoshi Kanno

引用次数: 0

Comment on "Investigation of the Optimal Interval of Perioperative Serum Flomoxef Administration in Hepatobiliary-Pancreatic Surgery". 对“肝胆胰手术围手术期血清氟莫昔最佳给药间隔的探讨”的评论。

IF 1.4 4区医学

Journal of Nippon Medical School Pub Date : 2026-01-01 DOI: 10.1272/jnms.JNMS.2026_93-203

Ugne Silinskaite, Jun Hirai, Akihisa Matsuda, Tomas Poskus, Hiroshi Yoshida

引用次数: 0